				<div class="form-group">
					<label class="col-xs-12 col-sm-3 col-md-2 left-label" ng-click="pagedata.edit(seh,'title','表单名称')">{{seh.title}}</label>
					<div class="col-xs-12 col-sm-8 col-lg-9">
						<div class="row row-fix tpl-district-container">
							<div class="col-xs-12 col-sm-4 col-md-4 col-lg-4">
								<select  class="form-control tpl-province">
								<option value="" selected="selected">年</option>
								</select>
							</div>
							<div class="col-xs-12 col-sm-4 col-md-4 col-lg-4">
								<select class="form-control tpl-city">
								<option value="" selected="selected">月</option>
								</select>
							</div>
							<div class="col-xs-12 col-sm-4 col-md-4 col-lg-4">
								<select class="form-control tpl-district">
								<option value="" selected="selected">日</option>
								</select>
							</div>
						</div>
						<div class="help-block" ng-click="pagedata.edit(seh,'help','表单提示信息')">{{seh.help}}</div>
					</div>
				</div>
